Local public health officials concerned with increase in vaccination exemptions – telegraphherald.com

Local health officials say a steady rise in exemptions from required childhood vaccinations, coupled with misinformation on their safety, is contributing to a concerning trend of fewer kids getting fully vaccinated.

While state data shows that nearly all local school-aged children have received the vaccines required to attend school or licensed child care centers, the small number with exemptions based on religious and personal conviction objections has been growing steadily for years.

Health officials from the local to the federal level have made it clear for decades that childhood vaccinations are safe and effective, but some parents remain wary as exemption numbers continue to climb. And health officials say the COVID-19 pandemic only made misinformation about vaccinations more prevalent, further pushing hesitant parents away.

Still, the federal Centers for Disease Control and Prevention notes that vaccines are tested and evaluated rigorously before they are approved for use to ensure they are as safe as possible. Vaccines are the best way to protect against serious diseases, the CDC states.

Allie White, executive director of the Dubuque County Public Health Department, said the upward trend of vaccine exemptions is concerning, though most kids still are getting their shots.

From a public health perspective, this increase that were seeing is definitely a cause for concern, she said. Were worried about the number of unvaccinated individuals and that it continues to trend upwards.

Exemption numbers increasingWhile the number of Iowa students with vaccine exemptions based on religious objections remains small, it has crept upward in recent years.

For the 2023-2024 school year, 3% of students in Iowa have religious exemptions from receiving at least one required vaccination, up from 2.6% in the 2022-2023 school year and 1.3% in the 2015-2016 school year, according to the Iowa Department of Health and Human Services.

In Dubuque County, 3.1% of students have religious exemptions in the current school year, compared to 3.6% in Clayton County, 2.1% in Delaware County and 2.8% in Jackson County.

That is an increase from the previous year, when the exemption rate was 2.7% in Dubuque County, 3.4% in Clayton County and 1.5% in Delaware County, though Jackson County saw no change in its rate. In the 2021-2022 school year, 2.3% of students had religious exemptions in Dubuque County, while the rate was 3.5% in Clayton County, 1.4% in Delaware County and 3% in Jackson County.

Hannah Porcic, lead nurse for Dubuque Community Schools, said the district hasnt seen an increase that would rise to a concerning level. District data shows that the percentage of students with religious exemptions increased from 2.03% in the 2018-2019 school year to 3.12% in the current school year.

A lot of times, its just helping educate them on the law requirements and guiding them to resources, Porcic said. I think parents just make the best choice that they feel is best for their family, and sometimes thats a medical or religious exemption.

Porcic said district nurses work with families to answer questions about vaccinations, help them understand their options and learn what is required by state law. Whether families need access to insurance, providers or exemption forms, nurses provide them with the information they need.

Laura Ryan, Western Dubuque Community School District lead nurse, wrote in an email to the Telegraph Herald that the district hasnt seen a noticeable increase in vaccine exemptions during the past few years. However, she said the district may see more of the effects of vaccine hesitancy as babies born during the COVID-19 pandemic start to enter school.

Deangela Brooks, of Dubuque, has four children and another on the way. She said she didnt really consider whether or not to vaccinate her children and that she did what was recommended by health care professionals during her pregnancies.

My (OB/GYN) recommended it, just for the safety of the baby when they were born, she said.

Religious conviction?Parents in Iowa and Illinois can pursue vaccine exemptions on either religious or medical grounds.

In both states, the medical exemption form requires a health care providers signature attesting that the relevant vaccines would harm the health of the child.

In Illinois, the religious exemption form requires a health care providers signature and requires parents to disclose which vaccines they want their child to be exempt from and the religious grounds for the request. Iowas religious exemption form only requires a notary and parent signatures agreeing that the immunization conflicts with a genuine and sincere religious belief and that the belief is in fact religious, and not based merely on philosophical, scientific, moral, personal or medical opposition to immunizations.

In addition to medical and religious exemption options, parents in Wisconsin also can receive a waiver from vaccine requirements based on personal conviction.

White, who worked as a school nurse before taking on her current role, said in her experience, most families who pursue a religious exemption actually just have a personal preference. She also said some parents might pursue an exemption because it is difficult for them to get transportation to vaccine appointments.

Unfortunately, sometimes its easier for a parent or caregiver to get an exemption form signed and notarized than it is to actually get them to receive the vaccine, she said. Sometimes I do believe that to be a barrier, as well.

Mary Rose Corrigan, city of Dubuque public health director, said that decades ago, parents had to cite a religion and the specific doctrine in that religion informing their beliefs against vaccinations, though that no longer is the case.

A person doesnt really have to be following a specific religion in order to have a religious exemption, she said. Its more of a philosophical viewpoint in some cases.

Other schools exemptionsVaccine exemption rates vary in southwest Wisconsin and northwest Illinois, with Wisconsin schools seeing higher rates generally.

According to the Wisconsin Department of Health Services, the percentage of students with religious waivers has remained similar over time, but the percentage of students with a personal conviction waiver increased from 1.2% in the 1997-1998 school year to 5% in the 2022-2023 school year.

For the 2022-2023 school year, 3% of students in Southwestern Wisconsin School District had a personal conviction waiver. Cuba City School District also had a 3% waiver rate, Platteville School District had 8%, Potosi School District had 6%, Lancaster Community School District had 5%, Darlington Community School District had 4% and Benton School District had 4%.

Jeff Kindrai, director of the Grant County Health Department, said the county did see a drop in the number of children ages 2 and younger who are up to date of their required vaccinations during the pandemic, though the numbers have gone back up to 57% in 2023. However, he said it isnt uncommon for surrounding counties to have immunization numbers much higher than that.

Since the pandemic, we have not gone in the direction weve wanted to see, he said.

Kindrai said that trend is concerning because some vaccine-preventable diseases are extremely contagious, making the area more susceptible to an outbreak if vaccination levels are lower.

Most vaccine hesitancy is based on misinformation, he said, so the department works to get accurate information and opportunities to people who need them.

In Illinois, the Galena and East Dubuque school districts reported fewer than 10 students with religious exemptions at each of their schools in the 2022-2023 school year, according to the Illinois State Board of Education.

Galena school district nurse Emily Rigopoulos said the vaccine compliance rate is high for Galena and that there are typically 5 to 10 students in the entire district with religious exemptions, out of a district population that last fall was more than 800. She said that number has stayed consistent since she began working there in 2020.

However, she said she has seen an increase in parents reaching out and asking for more information on vaccinations since the COVID-19 pandemic.

I think its just more they want to be informed of what their child actually needs and whats required of them, she said. They do end up getting vaccinated, and I havent really had a lot of pushback, thankfully.

Lori Stangl, director of clinical services for the Jo Daviess County Health Department, said her department hasnt seen much hesitation when it comes to routine childhood vaccinations, but the county continues to see low COVID-19 vaccination rates.

I think most people, we give them all of the vaccine information statements prior to them receiving it, and its well received, she said. Theres not a lot of people having too many questions or doubts with vaccines any more than was prior to (COVID-19.)

Pandemics rolePublic health officials said a rise in misinformation about the safety of vaccines that spread on the heels of the COVID-19 pandemic only has hindered attempts to get hesitant parents on board with getting kids their shots.

The CDC notes that beliefs that the COVID-19 vaccine gives the recipient the virus, affects fertility or contains unsafe ingredients are all incorrect myths. Indeed, the CDC notes that COVID-19 vaccines were rolled out under the most intense safety monitoring in U.S. history and that agencies continue to monitor the shots safety.

Still, some parents remain hesitant about the COVID-19 vaccine in particular, though it is not a required school vaccine in Iowa, Illinois or Wisconsin.

Lora Small, of Dubuque, said her kids have all their vaccines required for school, but none have the COVID-19 vaccine.

(The childhood vaccines) have been out for years, and the COVID-19 vaccine came out just not even a few months after COVID-19. No, I dont trust it, she said.

Laura Knabel, a registered nurse at UnityPoint Health-Visiting Nurse Association, tied the increase in vaccine exemptions in part to the pandemic.

What is interesting to me is, were seeing more kids who have all of their vaccines up until (the COVID-19 pandemic) and then fell off, she said.

She said VNA spends a lot of time with patients trying to debunk myths and conspiracies about vaccines and instead provide them with the facts about generally mild side effects and the diseases shots prevent.

You should always be educated about what is happening to your kids, but you need to be educated by professionals, she said.

The CDC notes on its website that vaccines go through a long process of laboratory testing and clinical trials to evaluate their safety before they can be approved for use. And even after that, health experts continue to monitor vaccines safety.

Millions of children safely are vaccinated each year, according to the CDC, and any side effects are almost always mild.

The disease-prevention benefits of getting vaccines are much greater than the possible side effects for almost all children, the CDC states.

Knabel also said many children with religious exemptions only lack one or two vaccines, but Iowas data doesnt capture how many are fully unvaccinated and how many are just missing one shot.

Return to routineCorrigan said the pandemic threw families off of their vaccine routines, so there has been emphasis on getting kids back on track in the past year. However, she said the pandemic also contributed to the spread of misinformation about vaccines.

Our influenza vaccination rates are lower than they have been, and its spilling over into some of the childhood diseases also, she said. But hopefully, as the pandemic recovery continues, we can boost our general immunization rates back up, but thatll take a few years for that to settle out.

White said her department works daily to communicate accurate and transparent information about vaccines, but they also lean on local providers who are often a familys most trusted source for health information.

Were definitely working to reduce misinformation to make sure theres accurate information out there, and to make sure that our providers have the tools they need to be able to share accurate information in a trusted manner with the families that they serve, White said.

She likewise noted that in addition to an uptick in misinformation about vaccines, the pandemic also disrupted childrens vaccination routines.

At times, that meant putting off routine doctors appointments and delaying vaccinations for some children. Once were out of that routine, its sometimes difficult to fall back into it, she said. I do think that that partially has contributed, as well.

Corrigan said widespread immunizations have led the U.S. to see a dramatic reduction in childhood communicable diseases such as measles, diphtheria and polio. However, that also means some parents arent familiar with the danger of those illnesses.

People are not aware of the severity and seriousness of these childhood diseases, she said. We continue to try to educate parents on those factors, on the importance of immunizations for children and their not only childhood health, but lifelong health.

Preventable diseases cropping upLocal officials cited a recent spike in measles cases 41 across the country as of late February as a result of waning vaccination rates.

Corrigan noted that recent measles outbreaks in surrounding states such as Minnesota and Missouri are affecting nonimmunized populations most.

Its always a concern, especially when we have incidents around the country of outbreaks of vaccine-preventable diseases, as is the case now, she said.

Jeff Sander-Welzien, infection preventionist for MercyOne Eastern Iowa Region, said in an email to the TH that the rise in religious exemptions is cause for concern, as seen by the surge in measles cases.

He said when fewer people are vaccinated, a resurgence of preventable diseases is expected.

Sander-Welzien said the best tool to fight misinformation is education. He frequently informs patients that a vaccination doesnt guarantee someone wont get an infection. Instead, it prevents individuals from being hospitalized or suffering complications from a disease.

He said childhood vaccines are safe, have gone through extensive testing and are an important part of protecting kids from sometimes life-threatening illnesses.

We are seeing the resurgence of vaccine-preventable diseases that can have devastating consequences for our most vulnerable children especially babies, he said in the email.

Corrigan also said it is disheartening to see the Iowa Legislature pursue bills she said erode the requirements for immunizations. The Iowa Senate recently approved a bill that would require school communications on vaccine requirements to also include information on exemptions and how to get them.

There are other bills that would change or lessen immunization requirements, which basically continues to erode public health authority to ensure that our communities are safe for everybody, she said.

Right information, resourcesOfficials said they spend time helping families get the resources they need to receive vaccines and providing as much information as possible once they get in the door.

For children who arent vaccinated because their families havent had access to a physician, Rigopoulos typically reaches out to the Jo Daviess County Public Health Department, and an employee there contacts the family.

Usually, the health department will set up a time to bring the child in and they can get immunized there at the health department, she said. The health department also can step in and help schedule for future vaccines.

Rigopoulos also collects updated information on resources that offer health assistance to families in need.

Corrigan said entities such as the VNA or Crescent Community Health Center provide multiple layers of vaccination opportunities for families, whether they have insurance or not.

We do a lot of work to review data to see whos not up to date on their immunizations through our statewide immunization database ... so we can contact and assist people who need to be brought up to date on their immunizations, she said.

Katie Felderman, a medical assistant at Crescent Community Health Center in Dubuque, said staff not only vaccinate kids at the center but also offer shots at local schools and at events. Crescent focuses on reaching uninsured and underinsured individuals, but it also serves those with private insurance.

Felderman said Crescent hasnt seen a major increase in families being hesitant to get their children vaccinated.

Alex Murphy, director of communications for the Iowa Department of Health and Human Services, said in an email to the TH that the department does year-long campaigns focused on the importance of vaccinations, working closely with local public health officials.

Ultimately, Iowa HHS encourages Iowans to ask their trusted health care provider about which immunizations are right for them and their children, he said in the email.

Mara Walker, of Dubuque, said she originally was a bit hesitant to vaccinate her kids after hearing misinformation such as that vaccines inject the virus into the recipient. After researching and finding that to be false, though, she decided to vaccinate them.

I think children should get vaccinated because it prevents a lot of things, she said. If (parents) do their research and really look into vaccinations, they will see the benefits of it. A lot of people just go by word of mouth and not do their own research.

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Local public health officials concerned with increase in vaccination exemptions - telegraphherald.com